A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?
Taking an HMG CoA reductase inhibitor.
Having a 10-year history of COPD.
Taking a high-ceiling diuretic.
Having a prolapsed mitral valve.
The Correct Answer is C
Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.
Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.
Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.
Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.
COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.
A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.
A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The FACES pain scale is a self-report tool that uses six facial expressions to indicate different levels of pain. It is suitable for children aged 3 to 13 years who can match their pain to a face. The nurse should use this scale to assess the pain of a 4-year-old child following an orthopaedic procedure.
Choice B. Word-graphic is wrong because it is a pain scale that uses words and pictures to describe pain intensity.
It is suitable for children aged 8 to 17 years who can read and understand words.
Choice C. Numeric is wrong because it is a pain scale that uses numbers from 0 to 10 to rate pain intensity. It is suitable for children aged 5 years and older who can understand numbers and concepts of more or less.
Choice D. CRIES is wrong because it is a pain scale that uses five behavioural indicators (crying, requiring increased oxygen, increased vital signs, expression, and sleeplessness) to measure pain in neonates.
It is suitable for infants aged 0 to 6 months who cannot communicate verbally.
Correct Answer is C
Explanation
This is the priority for the nurse to report to the provider because cefuroxime is a cephalosporin antibiotic that can cause serious or life-threatening allergic reactions in people who are allergic to penicillin. The nurse should not administer cefuroxime to this client until the provider is notified and an alternative antibiotic is prescribed.
Choice A is wrong because the client has a BUN level of 18 mg/dL, which is within the normal range of 7 to 20 mg/dL.
This does not indicate any renal impairment or adverse reaction to cefuroxime.
Choice B is wrong because the client reports a history of nausea with cefuroxime, which is a common side effect of this drug.
The nurse should instruct the client to take cefuroxime with food to reduce nausea, but this is not a priority to report to the provider.
Choice D is wrong because the client takes aspirin daily, which does not interact with cefuroxime.
The nurse should monitor the client for any signs of bleeding or bruising while taking aspirin, but this is not a priority to report to the provider.
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